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Infectious Diseases in Respiratory Medicine
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Infectious Diseases in Respiratory Medicine

A special issue of Advances in Respiratory Medicine (ISSN 2543-6031).

Deadline for manuscript submissions: 26 September 2026 | Viewed by 6139

Editor

Dr. Kay Choong See

E-Mail Website
Guest Editor
Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore 119228, Singapore
Interests: respiratory infection; intensive care medicine; public health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to this Special Issue, “Infectious Diseases in Respiratory Medicine”. Infectious diseases continue to represent a major cause of morbidity and mortality worldwide, with respiratory infections ranking among the most common and severe. The recent global experience with COVID-19 has highlighted the critical need for continued research into the diagnosis, treatment, and prevention of respiratory infections. Beyond emerging viral pandemics, bacterial, fungal, and mycobacterial respiratory infections remain highly prevalent, with substantial impact on healthcare systems, patient quality of life, and long-term outcomes. Advancing our understanding in this field is therefore essential for improving patient care and public health.

This Special Issue aims to bring together cutting-edge research and expert perspectives on infectious diseases affecting the respiratory system. It will cover diverse aspects of pathogenesis, diagnostics, therapeutics, and prevention strategies. The focus of this Special Issue aligns closely with the scope of the journal, which emphasizes advances in the understanding and management of respiratory disorders. We expect this collection to be of great interest to clinicians, researchers, and policymakers involved in respiratory and infectious disease medicine.

In this Special Issue, we welcome original research articles, systematic reviews, meta-analyses, and narrative reviews. Research areas may include, but are not limited to, the following themes:

  • Viral respiratory infections (e.g., influenza, SARS-CoV-2, RSV);
  • Bacterial pneumonias and antimicrobial resistance in respiratory medicine;
  • Tuberculosis and non-tuberculous mycobacterial lung disease;
  • Opportunistic infections in immunocompromised hosts;
  • Fungal respiratory infections (e.g., aspergillosis, endemic mycoses);
  • Advances in rapid diagnostics and molecular testing;
  • Vaccines and preventive strategies in respiratory infectious diseases;
  • Host immune response and pathophysiology of respiratory infections;
  • Emerging pathogens and global health perspectives;
  • Infection control and public health implications.

We look forward to receiving your valuable contributions.

Sincerely,
Dr. Kay Choong See
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Advances in Respiratory Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • respiratory tract infections
  • pneumonia, viral
  • pneumonia, bacterial
  • tuberculosis, pulmonary 
  • mycoses
  • drug resistance, microbial
  • vaccines
  • immunocompromised host 
  • diagnostic techniques and procedures 
  • emerging infectious diseases

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  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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21 pages, 6332 KB  
Article
Microglia-Mediated Ependymal Injury in Bacille Calmette-Guérin-Induced Meningitis Is Attenuated by Sodium Butyrate with Restoration of Hmgcs2 Expression
by Yang Ren, Danni Chen, Shiqi Xie, Yawen He, Xuanru Zhuang, Dan Ye, Zhentao Fei, Lu Xia, Yongjie Wang and Feng Li
Adv. Respir. Med. 2026, 94(4), 54; https://doi.org/10.3390/arm94040054 - 27 Jul 2026
Abstract
Background: Tuberculous meningitis (TBM) is the most severe form of central nervous system tuberculosis, associated with high mortality and neurological sequelae. Microglia-driven neuroinflammation is a key contributor to TBM pathogenesis; however, its specific effects on ependymal cells—critical for cerebrospinal fluid dynamics and barrier [...] Read more.
Background: Tuberculous meningitis (TBM) is the most severe form of central nervous system tuberculosis, associated with high mortality and neurological sequelae. Microglia-driven neuroinflammation is a key contributor to TBM pathogenesis; however, its specific effects on ependymal cells—critical for cerebrospinal fluid dynamics and barrier function—and potential therapeutic strategies remain unclear. Methods: A murine TBM model was established by tail vein injection of BCG. Although the virulence of BCG, an attenuated strain of Mycobacterium bovis, is different from that of clinically isolated human Mycobacterium tuberculosis, its induced phenotypes such as periventricular inflammatory infiltration, microglia activation, and ependymal dysfunction highly reproduce the key histopathological features of human TBM. Primary ependymal cells were cultured and treated either directly with BCG or indirectly with conditioned medium from BCG-stimulated BV2 microglial cells (BCG+BV2-CM). Transcriptomic profiling was conducted via RNA sequencing, with validation by qPCR and Western blot. Functional outcomes, including ciliary morphology and apoptosis, were assessed using immunofluorescence and flow cytometry. The therapeutic effect of sodium butyrate (NaB) was evaluated through pretreatment experiments. Results: BCG infection induced characteristic TBM pathology, with persistent bacteria in the brain and lungs, ventricular inflammation, and pulmonary damage. Transcriptomic analysis showed that direct BCG treatment altered the expression of 1036 genes in ependymal cells, whereas BCG+BV2-CM treatment induced 3558 differentially expressed genes, highlighting microglia’s role in amplifying ependymal injury. Integrated analysis identified 64 consistently dysregulated genes across in vitro and in vivo models, enriched in immune and metabolic pathways. BCG challenge significantly downregulated Hmgcs2, leading to ciliary shortening and increased apoptosis. Sodium butyrate treatment restored Hmgcs2 expression, preserved ciliary structure, and reduced apoptosis. Conclusion: Microglia profoundly exacerbate transcriptional dysregulation in ependymal cells during TBM. Sodium butyrate confers protection against BCG-induced ependymal damage by upregulating Hmgcs2, revealing a novel therapeutic target for tuberculous meningitis. Full article
(This article belongs to the Special Issue Infectious Diseases in Respiratory Medicine)
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15 pages, 757 KB  
Article
Clinical Impact of RSV Vaccination in Hemodialysis Patients: Real-World Evidence on Hospitalization Risk and the Role of Chronic Lung Disease
by Francesca K. Martino, Francesca Fioretti, Lucia Federica Stefanelli, Gianni Carraro, Miriam Capuano, Giuseppe Scaparrotta and Federico Nalesso
Adv. Respir. Med. 2026, 94(4), 45; https://doi.org/10.3390/arm94040045 - 2 Jul 2026
Viewed by 320
Abstract
Background: Respiratory syncytial virus (RSV) infection is a cause of respiratory morbidity in high-risk patients, including those with chronic lung disease (CLD) and those undergoing hemodialysis (HD). In HD patients, evidence on the clinical impact of RSV vaccination on respiratory complications remains limited. [...] Read more.
Background: Respiratory syncytial virus (RSV) infection is a cause of respiratory morbidity in high-risk patients, including those with chronic lung disease (CLD) and those undergoing hemodialysis (HD). In HD patients, evidence on the clinical impact of RSV vaccination on respiratory complications remains limited. We aimed to assess the clinical impact of RSV vaccination in HD patients by comparing vaccinated and unvaccinated patients with a focus on CLD. Methods: We retrospectively evaluated 56 adult HD patients: 28 received the RSV vaccine in autumn 2024 and 28 did not. Clinical data were collected from electronic medical records. Outcomes included influenza-like illness (ILI), pneumonia, and respiratory infection requiring hospitalization between September 2024 and September 2025. Results: Patients had a mean age of 74.4 years and a median Charlson Comorbidity Index (CCI) of 10. The RSV-vaccinated group had a greater comorbidity burden than the unvaccinated group (CCI 11 IQR 10–12 vs. 9 IQR 8–11, p = 0.02) and a higher prevalence of CLD (46.4% vs. 25.0%, p = 0.09). During follow-up, 28 patients (50.0%) had at least one ILI episode, 23 (41.1%) developed pneumonia, and 15 (26.8%) were hospitalized for respiratory infection. The incidence of ILI was 46.4% in vaccinated patients and 53.6% in unvaccinated patients (p = 0.28), while the incidence of pneumonia was 39.3% and 42.9%, respectively (p = 0.78). Respiratory infection requiring hospitalization occurred in 14.3% of vaccinated patients and 39.3% of unvaccinated patients (p = 0.035). CLD was significantly associated with pneumonia (p = 0.001) and showed trends toward higher rates of ILI (p = 0.09) and hospitalization for respiratory infection (p = 0.1). Conclusions: In our exploratory study, RSV vaccination in HD patients was associated with fewer hospitalizations for respiratory infection, despite greater comorbidity in vaccinated patients. CLD was associated with a higher incidence of respiratory complications, particularly pneumonia. The retrospective design and small sample size do not allow definitive conclusions; future prospective studies with an adequate sample size are needed to confirm our results. Full article
(This article belongs to the Special Issue Infectious Diseases in Respiratory Medicine)
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15 pages, 1100 KB  
Article
Pulmonary Actinomycosis: A Hidden Threat with Clinical Impact
by Raffaella Griffo, Jasmin K. Jasuja, Benedikt Niedermaier, Sabine Wege, Janina Shala, Henrike Deissner, Lena Brendel, Romina M. Rösch, Florian Eichhorn, Michael Allgäuer, Elizabeth Tong, Cosmas Wimmer, Martin E. Eichhorn, Hauke Winter and Laura V. Klotz
Adv. Respir. Med. 2026, 94(3), 33; https://doi.org/10.3390/arm94030033 - 18 May 2026
Viewed by 881
Abstract
Background: Pulmonary actinomycosis is a rare chronic infection that frequently mimics lung malignancy, often leading to delayed diagnosis due to its non-specific clinical and radiological presentation. Given the diagnostic challenges associated with this condition, the aim of this study was to evaluate the [...] Read more.
Background: Pulmonary actinomycosis is a rare chronic infection that frequently mimics lung malignancy, often leading to delayed diagnosis due to its non-specific clinical and radiological presentation. Given the diagnostic challenges associated with this condition, the aim of this study was to evaluate the clinical presentation, diagnostic pathways, treatment strategies, and outcomes of patients diagnosed with pulmonary actinomycosis in a single center. Methods: We retrospectively reviewed patients diagnosed with pulmonary actinomycosis at our institution between January 2014 and December 2022. Diagnosis was established based on compatible clinical and radiological findings together with microbiological identification of Actinomyces by culture or polymerase chain reaction. Results: Twenty-two patients were included in the final analysis. The median age was 61.5 years and males were more frequently affected (59%). The median time from initial hospitalization to definitive diagnosis was 70 days. Actinomyces odontolyticus was the most frequently identified species. All patients received antibiotic therapy, with a median treatment duration of 45.5 days. Thirteen patients underwent surgical intervention, performed either for diagnostic purposes or for treatment of complications. Complete disease eradication through surgical management was achieved in six cases. During follow-up (median 24 months), overall survival at three years was 78%, with one death directly related to pulmonary actinomycosis. Conclusions: Pulmonary actinomycosis remains a diagnostic challenge due to its non-specific clinical presentation and low microbiological yield. Early clinical suspicion and a combined diagnostic approach including bronchoscopy and microbiological testing are essential for timely diagnosis. Surgical intervention may play an important diagnostic and therapeutic role in selected patients. Full article
(This article belongs to the Special Issue Infectious Diseases in Respiratory Medicine)
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7 pages, 575 KB  
Communication
The Role of L-Arginine and Liposomal Vitamin C Supplementation as an Adjunct in Seasonal Respiratory Viral Infection Recovery
by Valentina Trimarco, Paola Gallo, Seyedali Ghazihosseini, Alessia Izzo, Paola Ida Rozza, Alessandra Spinelli, Stefano Cristiano, Carlo De Rosa, Felicia Rozza and Carmine Morisco
Adv. Respir. Med. 2026, 94(1), 11; https://doi.org/10.3390/arm94010011 - 9 Feb 2026
Viewed by 1581
Abstract
Respiratory seasonal viral infections remain one of the most important issues in community medicine. The heterogeneity of etiological agents and the characteristics of the hosts airway antiviral defenses account for the complex management of these infections. The clinical consequence of this picture is [...] Read more.
Respiratory seasonal viral infections remain one of the most important issues in community medicine. The heterogeneity of etiological agents and the characteristics of the hosts airway antiviral defenses account for the complex management of these infections. The clinical consequence of this picture is that, despite the widespread use of vaccination as the primary prevention strategy, the rates of acute respiratory complications remain still high. In addition, they determine post-infectious fatigue and organ dysfunction. Inflammation and oxidative stress are the principal pathogenic mechanisms responsible for clinical complications during respiratory seasonal viral infections. Nowadays, a growing body of evidence indicates that adjunctive nutritional support can contribute to relieve the symptoms during the acute and subacute phases of respiratory viral infections. We assess the data in the literature regarding the combination of L-Arginine and Liposomal Vitamin C as adjuvant treatment for respiratory seasonal viral infections. The database of the National Library of Medicine (PubMed) was searched using the keywords “L-Arginine, Vitamin C, dietary supplements, seasonal respiratory viral infections”. The treatment of symptoms during acute and post-acute respiratory viral infections requires an integrated approach that includes vitamins and nutritional supplementation. The combination of L-Arginine and Liposomal Vitamin C seems to represent a nutritional support able to mitigate symptoms occurring during the acute or post-acute phase of infection. Full article
(This article belongs to the Special Issue Infectious Diseases in Respiratory Medicine)
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Review

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43 pages, 2987 KB  
Review
Clues to Long COVID Linked to Virulence and Infectivity Found in Shell Proteins
by Gerard Kian-Meng Goh, James A. Foster and Vladimir N. Uversky
Adv. Respir. Med. 2026, 94(2), 18; https://doi.org/10.3390/arm94020018 - 11 Mar 2026
Viewed by 2381
Abstract
Clinical, experimental, and computational evidence of COVID-19 virulence and infectivity has been linked to SARS-CoV-2 shell disorder. A strong link was first discovered using an AI disorder-predicting tool, which detected an unusually hard (low disorder) outer shell among all SARS-CoV-2-related viruses but not [...] Read more.
Clinical, experimental, and computational evidence of COVID-19 virulence and infectivity has been linked to SARS-CoV-2 shell disorder. A strong link was first discovered using an AI disorder-predicting tool, which detected an unusually hard (low disorder) outer shell among all SARS-CoV-2-related viruses but not in the 2003 SARS-CoV-1. This could account for the high infectivity found in SARS-CoV-2—but not in SARS-CoV-1—as it is believed that hard shells protect viral particles from the onslaught of the antimicrobial enzymes present in the respiratory system and saliva. As a result, much larger quantities of particles are shed by COVID-19 patients. Abnormally hard outer shells (M) are associated with burrowing animals, e.g., pangolins, and SARS-CoV-2 likely acquired these shells due to its long-term evolutionary interactions with pangolins. As for virulence, the inner shell of SARS-CoV-2 (N) has been found to exhibit lower disorder than that of SARS-CoV-1. This lower disorder is consistent with the fact that SARS-CoV-2 is less virulent than SARS-CoV-1, as higher disorder in the inner shell is associated with more efficient protein–protein binding during replication. The link between N/M disorder and virulence or infectivity falls under the umbrella of shell disorder models (SDMs), which can connect virulence, infectivity, and long COVID under one coherent concept. Evidence of the reliability and reproducibility of SDMs as applied to COVID-19 is examined. The hard M that is resisting the antimicrobial enzymes in the respiratory system can be extended to immunological enzymes, especially those found in phagocytes such as macrophages, which can therefore become a reservoir for the virus. Full article
(This article belongs to the Special Issue Infectious Diseases in Respiratory Medicine)
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